囊性淋巴管瘤的特征及超声诊断

目的：探讨囊性淋巴管瘤的特征及其超声诊断价值。方法：搜集经病理证实的32例囊性淋巴管瘤资料,术前均作超声检查。回顾性分析其超声表现。并与手术、病理结果对照。结果：根据囊性淋巴管瘤的发生部位将其分为3组;疏松间隙组（23例）,体表软组织组（6例）,内脏组（3例）,分析其超声表现。结论：囊性淋巴管瘤具有其特异的超声表现;超声检查对大多数病例定位及定性诊断均具重要价值。     

淋巴管瘤的超声特征分析

目的探讨淋巴管瘤的二维及彩色多普勒声像图表现特征。方法回顾分析30例淋巴管瘤患者的声像图资料,与手术病理资料对比分析,总结其特点。结果根据淋巴管瘤的发生部位将其分为疏松间隙处17例,体表软组织处10例及内脏处3例;按其病理分型分为囊性淋巴管瘤18例和海绵状淋巴管瘤12例;根据超声表现分为囊肿型23例,囊实混合型5例,强回声型2例。结论不同病理分型的淋巴管瘤其发生部位和超声表现有一定差异。超声检查对大多数淋巴管瘤的定位及定性诊断具有重要价值。     

腹部囊性淋巴管瘤的超声诊断

目的：探讨腹部囊性淋巴管瘤的超声表现及诊断价值。方法：对11例腹部囊性淋巴管瘤术前B型超声检查结果进行回顾性分析并与手术及病理对照，总结声像图表现。结果：腹部囊性淋巴管瘤声像图表现为边界清晰。壁薄，内多呈多房结构(10／11)囊性包块，囊性暗区内清晰，包块与周边脏器分界清楚，无腹水。结论：B型超声对腹部囊性淋巴管瘤诊断有重要临床价值，应作为首选的检查方法。     

小儿颈部囊性病变的高频超声诊断与鉴别诊断

目的：探讨小儿颈部囊性病变的高频超声表现特征。方法：搜集42例经手术病理证实的颈部囊性病变，均行超声检查，回顾性分析其超声特点。结果：甲状舌管囊肿19例（45．24％），颈淋巴管瘤15例（35．71％），鳃裂囊肿8例（19．05％）。颈部囊性病变各有其好发部位，且病变具有一定的超声特征。甲状舌管囊肿多见于颈中线附近、舌骨上下；淋巴管瘤多见于颈侧部、锁骨上，范围较广；腮裂囊肿多见于中上侧颈部。甲状舌管囊肿及鳃裂囊肿呈单房性，淋巴管瘤多为多房性。结论：超声检查可清晰显示病变的大小、形态和延伸范围，多数能定性诊断，对颈部囊性病变具有重要的诊断和鉴别诊断价值。     

小儿颈部淋巴管瘤的CT诊断3例报告及文献复习

目的：分析小儿淋巴管瘤的CT表现和病理基础，探讨CT检查对小儿淋巴管瘤的诊断价值。方法：对3例经手术、病理证实的小儿颈部淋巴管瘤的CT表现进行研究。结果：2例为多囊状不规则形水样密度肿块，增强扫描无明显强化，多囊、囊腔相通，大小不一，肿瘤沿颈部筋膜间隙生长，累及周围脏器，部分邻近器官受压推移。结论：CT检查能较准确地显示出淋巴管瘤部位、范围、内部特征等，因而对其定位和定性有较大价值。     

囊性淋巴管瘤18例超声诊断分析和鉴别

目的 探讨囊性淋巴管瘤超声特征.方法 收集分析经病理证实18例囊性淋巴管瘤,术前均做超声检查,回顾性分析及超声表现,并与手术与病理结果对照.结果 右颈及颌下8例,左颈及颌下2例,左颈前及肩部4例,单纯颌下6例;Ⅰ型5例,Ⅱ型10例,Ⅲ型5例;7例血流丰富,10例血流不丰富.结论 淋巴管瘤好发于头颈部、颈肩部、躯干、腹膜后、及四肢等.不同部位其声像图特征有所差异,超声检查对大多数淋巴管瘤具有重要价值.     

小儿颈部先天性囊性肿块58例超声诊断分析

目的：探讨超声对小儿颈部先天性囊性肿块的诊断及鉴别诊断价值。方法：回顾性分析58例经手术病理证实的小儿颈部先天性囊性肿块的超声表现及发病部位,总结不同病理类型囊性肿块的声像图特征。结果：甲状舌管囊肿29例,颈淋巴管瘤24例,腮裂囊肿5例,各有其好发部位及特异性声像图表现。结论：小儿颈部各类先天性囊性肿块的发病部位及超声表现不同,对诊断及鉴别诊断具有重要价值。     

胎儿少见部位淋巴管瘤的超声与磁共振成像诊断CSCD

目的总结胎儿少见部位淋巴管瘤(CH)产前超声及磁共振成像(MRI)诊断的图像特征。方法对2010年7月至2015年1月广州市妇女儿童医疗中心产前超声检查发现淋巴管瘤的160例胎儿行标准化超声切面检查,排除胎儿颈部淋巴管瘤和全身淋巴水囊瘤135例,对25例少见部位淋巴管瘤胎儿超声声像图特征及磁共振图像(16例)进行分析并与胎儿羊水或脐血染色体检查结果对照,追踪胎儿妊娠结局。结果 25例少见部位胎儿淋巴管瘤均于孕中、晚期发现,25例胎儿产前影像学及染色体检查结果:(1)超声表现:25例胎儿超声显示淋巴管瘤发生在胸壁和(或)腹壁8例,上肢或下肢5例,颜面部或颏部4例,腋下3例,腰背部4例,骶尾部1例。超声声像图示皮下多房囊性包块,呈均质无回声、弱回声或低回声,边界清晰,内部有明显高回声分隔带。(2)磁共振表现:超声检查后16例胎儿行磁共振检查示皮下脂肪层囊状信号影,囊壁薄,T2WI呈高信号影,T1WI呈低信号影,内见不完全线状分隔;4例临近淋巴管瘤部位的胸廓、肺、口腔周围软组织受压变形。(3)脐血染色体检查:超声检查后24例胎儿染色体检查未见异常,1例脐血检查诊断为染色体异常嵌合体,核型45,X[10]/46,XX[90]。(4)胎儿妊娠结局:产前超声及MRI检查后孕妇选择引产7例,产后存活13例均于生后1~9个月行介入性手术治疗。介入性手术治疗后12例均正常,仅1例治疗后复发需二次介入手术;4例未分娩仍在随访,1例失访。结论胎儿少见部位淋巴管瘤具特征性超声及磁共振表现,超声多显示为皮下多房囊性包块,MRI T2WI囊状高信号影,T1WI低信号,MRI检查有利于明确淋巴管瘤对周围组织尤其对气管有无压迫,定期超声监测有助于产前明确诊断及临床干预治疗。     

超声诊断淋巴管瘤的价值

目的 探讨淋巴管瘤的特征及其超声诊断价值.方法 分析经病理证实的36例淋巴管瘤的声像图特点,并与手术、病理结果对照.结果 淋巴管瘤好发于儿童,尤其是婴幼儿;颈部17例,发生率为47.22%,腋下6例,发生率为16.67%,体表7例,发生率为19.44%,其他发生于腹腔、脾等处.结论 超声检查对大多数淋巴管瘤的定位及定性诊断均具重要价值.     

经腹超声、64排螺旋CT对腹腔淋巴管瘤的诊断价值(附5例报告)

目的:探讨经腹超声、64排螺旋CT对腹腔淋巴管瘤的诊断价值。材料与方法:回顾性分析经手术、病理证实腹腔淋巴管瘤5例,均行腹部超声、CT检查,其中3例行CT增强扫描。结果:经腹超声及CT检查腹腔淋巴管瘤表现为腹腔内单房性囊肿2例,多房性囊肿3例,淋巴管瘤沿组织间隙内生长,形状不规则,界限清晰,直径约3-17cm不等。2例囊性肿块内可见血管及穿行小肠组织。3例CT增强扫描囊壁强化,分隔轻度强化,囊内液性部分无强化。术前经腹超声正确诊断2例,正确率40%,CT正确诊断4例,正确率80%。结论:腹腔淋巴管瘤是临床少见腹腔病变,其影像表现为腹腔内单房或多房囊肿,沿组织间隙生长,形态多不规则为特征,术前借助经腹超声、CT检查综合分析,可为临床治疗提供重要价值。     

腺性膀胱炎的超声诊断与分型

目的： 研究腺性膀胱炎的声像图特点、病理基础、诊断价值及其临床意义。方法： 回顾性分析１４ 例经手术病理证实的腺性膀胱炎的声像图资料, 就其病理与超声显像的关系及超声鉴别诊断进行了分析。结果： 本组超声诊断符合率为７９％ （１１／１４ 例）。根据超声所见并结合手术后病理结果, 将其声像图表现分为四型： Ⅰ型： 乳头增生型２ 例; Ⅱ型： 结节增生型 ２ 例; Ⅲ型： 弥漫增生肥厚型４ 例; Ⅳ型： 混合增生型 ６ 例。结论： 超声对腺性膀胱炎的定位和定性具有重要的诊断价值, 结合病史和临床表现可减少误诊。     

超声引导穿刺活检对原发性甲状腺淋巴瘤的诊断价值

目的 　探讨原发性甲状腺淋巴瘤（primary thyroid lymphoma, PTL）的超声特征及超声引导甲状腺活检的诊断价值。方法 　回顾性分析2003年至2013年北京协和医院22例经病理证实的PTL患者的临床资料（年龄32～81岁,中位年龄61岁）、超声声像图表现及活检方式,将PTL超声表现分为3型,即弥漫型、结节型和混合型。结果 　22例PTL患者的主要病理类型为黏膜相关淋巴组织B细胞淋巴瘤（45.5%,10/22）和弥漫性大B细胞淋巴瘤（36.4%,8/22）。16例PTL患者（72.7%）首发症状为颈部肿物近期明显增大。22例PTL患者中16例（72.7%）超声诊断为恶性或可疑恶性,6例（27.3%）超声诊断为良性。10例行超声引导细针抽吸活检,其中仅2例诊断可疑PTL;9例行超声引导组织活检,其中8例获得明确病理诊断。15例PTL患者接受外科手术活检,获得病理诊断。PTL超声声像图特征分为弥漫型（45.5%,10/22）、结节型（40.9%,9/22）和混合型（13.6%, 3/22）。结论 　超声声像图特征有助于PTL诊断,尤其是对有近期颈部肿物迅速增大病史的患者。超声引导组织活检安全、准确,是诊断PTL的首选方法。     

Imaging findings of Castleman disease of the abdomen and pelvis

BACKGROUND: The purpose of this study was to analyze the characteristic features of Castleman disease in the abdomen and pelvis as suggested by imaging findings in order to deepen the recognition and understanding of this rare disease. METHODS: A group of ten patients with pathologically proven Castleman disease in the abdomen (n = 9) and pelvis (n = 1) were included in this study. Patients were 18 approximately 56-year-old (mean = 40); seven of them were men and three were women. Imaging findings (CT&MRI, n = 4; only CT, n = 4; only MRI, n = 2) were retrospectively reviewed and correlated with clinical and pathologic findings. RESULTS: The lesions were divided into those with localized Castleman (n = 9) and disseminated Castleman (n = 1). The pathologic subtype of all nine cases of localized disease was hyaline vascular with six patients showing a solitary mass and three having a single dominant mass surrounded by small satellite nodules. On nonenhanced CT images, the lesions were manifested as homogeneous masses of soft tissue attenuation, which was isoattenuated relative to normal muscle. On MRI, the lesions were isointense or slightly hypointense compared with that of normal muscle on T1-weighted images and hyperintense on T2-weighted images. After intravenous injection of contrast media, most of the masses (7/9) showed marked enhancement and slow washout with the degree of enhancement approaching that of the large arteries. And in the interior of four cases of larger masses (>5 cm) was observed fissured and radial patterns in both low-density area on CT and low-signal area on MRI. These patterns were pathologically proved to be fibrous. The pathological subtype of a sole disseminated case was plasma-cell type, where imaging findings showed a lining of well defined, sharply enhanced soft-tissue nodules in retroperitoneal zone. CONCLUSION: Imaging findings of Castleman disease in the abdomen and pelvis are closely related to pathological type diagnosed. The characteristic features of localized and hyaline vascular type of Castleman disease include a solitary mass or a dominant mass surrounded with small satellite nodules, and high enhancement and slow washout with the degree of enhancement approaches that of large arteries. The presence of central areas of fibrosis of the larger tumors is one of the characteristic features of this disease.     

超声引导组织活检对原发性甲状腺淋巴瘤的诊断价值

  目的  探讨原发性甲状腺淋巴瘤(primary thyroid lymphoma, PTL)的超声特征及超声引导甲状腺活检的诊断价值。  方法  回顾性分析2003年至2013年北京协和医院22例经病理证实的PTL患者的临床资料(年龄32~81岁, 中位年龄61岁)、超声声像图表现及活检方式, 将PTL超声表现分为3型, 即弥漫型、结节型和混合型。  结果  22例PTL患者的主要病理类型为黏膜相关淋巴组织B细胞淋巴瘤(45.5%, 10/22)和弥漫性大B细胞淋巴瘤(36.4%, 8/22)。16例PTL患者(72.7%)首发症状为颈部肿物近期明显增大。22例PTL患者中16例(72.7%)超声诊断为恶性或可疑恶性, 6例(27.3%)超声诊断为良性。10例行超声引导细针抽吸活检, 其中仅2例诊断可疑PTL; 9例行超声引导组织活检, 其中8例获得明确病理诊断。15例PTL患者接受外科手术活检, 获得病理诊断。PTL超声声像图特征分为弥漫型(45.5%, 10/22)、结节型(40.9%, 9/22)和混合型(13.6%, 3/22)。  结论  超声声像图特征有助于PTL诊断, 尤其是对有近期颈部肿物迅速增大病史的患者。超声引导组织活检安全、准确, 是诊断PTL的首选方法。     

细支气管肺泡癌的CT诊断

目的:探讨细支气管肺泡癌的CT表现。方法:回顾性分析经病理证实的BAC48例,进一步了解其CT表现特征。结果:BAC按影像表现分为三种类型:孤立结节型、肺炎型、弥漫型。本组分别有30例、12例、6例。孤立结节型病灶多位于外周(96·7%),同时具有分叶、毛刺、空泡征、胸膜凹陷的22例(73·3%);肺炎型中,均匀实变的7例(58·3%),蜂窝状实变2例(16·7%);磨玻璃样改变3例(25%)。支气管气相5例(71·4%),枯枝征4例(57·1%),CT血管造影征3例(42·9%);弥漫型6例均表现为双肺弥漫性分布的腺泡结节影。HRCT有助于病灶的显示。结论:熟悉BAC的CT征象,可以提高诊断正确率,减少误诊。     

超声对体表淋巴管瘤的诊断价值

目的研究二维及彩色多普勒超声对体表淋巴管瘤的诊断价值.方法回顾21例术后病理证实为体表淋巴管瘤超声声像图,分析体表淋巴管瘤声像图特点.结果淋巴管瘤超声声像图大致分三种:单纯型、分房型、混合型.单纯型无明显血流信号,分房型及混合型分隔上及壁上可见血流信号,尤其是当混有其他组织成分时.常与血管瘤、单纯囊肿、鳃裂囊肿、皮脂腺囊肿、皮样囊肿难于鉴别.结论超声对体表淋巴管瘤的诊断及辅助治疗有重要价值.     

卵巢甲状腺肿的CT表现

目的探讨卵巢甲状腺肿（SO）的CT表现,提高影像学诊断水平。方法对18例经手术病理证实的SO患者的临床资料进行回顾性分析,并结合术后病理探讨其CT成像基础,总结其CT表现。结果 18例患者中17例（94.4%）单侧发病,1例（5.6%）双侧发病;19个病灶中多房囊性9个（47.4%）,囊实性7个（36.8%）,实性3个（15.8%）,所有病灶边界清楚。囊性及囊实性病灶囊液CT值25～70 HU,平均45 HU,3个实性病灶均明显强化;含脂肪组织病灶6个（31.6%）,含钙化者9个（47.4%）;2例患者（11.1%）出现少量腹水。结论 SO的CT特征为单侧,多房囊性、囊实性肿块,边界清,囊内液较稠,实性病灶明显强化,常合并有脂肪及钙化,部分患者合并腹水。结合B超、MRI及临床表现术前诊断是有可能的。     

Gastrointestinal tract lymphangiomas: findings at CT and endoscopic imaging with histopathologic correlation

Objective  To evaluate and describe CT and endoscopic imaging findings in patients with pathologically confirmed gastrointestinal tract lymphangiomas. Methods  Findings from imaging examinations in 6 patients with pathologically confirmed lymphangioma were retrospectively reviewed (computed tomographic images obtained in 6 patients and endoscopic images obtained in 4 patients were available for review). Two radiologists evaluated lesion location, size, shape, edge, number, attenuation, the thickness of capsule wall and the degree of enhancement through PACS or workstation. Results  Lymphangiomas in gastrointestinal tract showed similar features in CT imaging: Contrast-enhanced CT scan showed the oval submucosal masses with homogeneous low attenuation. The lymphangioma appeared as a well-defined, smoothly marginated and non-enhancing cystic mass with intact overlying intestinal mucosa. In one case, the lymphangiomas were multiple with volvulus. Remarkably, CT imaging showed 2 patients with intussusception due to the mass. Endoscopic photographs manifested multiple colplanate mucosal protrusions in the gastric wall or intestinal wall. One case showed submucosal pedunculated proliferative lesion with adenomatous surface. Conclusions  Lymphangiomas exhibited typical appearances that reflected their cystic pathologic features. They showed similar features in CT imaging: well-demarcated, non-enhancing, homogeneous low attenuation cystic masses with intact overlying mucosa. Endoscopic photographs showed submucosal masses with distension of overlying mucosal vessels.